RARE-25. A RETROSPECTIVE, SINGLE INSTITUTION STUDY OF CENTRAL NEUROCYTOMA (2004-2016): SURVIVAL, TREATMENT, AND SUPPORTIVE CARE

OBJECTIVE Central neurocytoma (WHO grade II) represents 0.25-0.5% of all primary brain tumors. Given its rarity, the management is typically described in small case series. We describe our institutional experience in terms of survival, treatment, pathologic correlates, and supportive care interventions. METHODS This is an IRB-approved retrospective analysis of patients treated in our institution between 12/31/2004 and 10/12/2016. MRI and pathology reports were reviewed and confirmed the diagnosis in 9 patients. Two additional patients did not consent and were excluded. RESULTS A total of 9 patients (2 females, 7 males) were identified with a mean age at diagnosis of 34.1 years (range 17-59, SD 15.0). All patients were alive at the time of analysis. 2 patients identified as Asian and 7 as White. The MiB labeling index (MiB) ranged from ≤2 to 20%. All underwent surgical resection and GTR was achieved in 5. Of those patients with GTR, 3 (MiB 3-5, 5 and 20%) received adjuvant radiotherapy (RT). A single patient with GTR and elevated MiB of 5% did not receive RT: this patient is progression-free at 38 months and is the only patient with a KPS of 100. There was a single case of recurrence in the patient with highest MiB (20%) treated with GTR, RT, and concurrent temozolomide. This patient is alive >10 years from diagnosis and 5.2 years after recurrence. A majority that received RT (n=6), were referred for neuropsychological evaluation with 4 patients requiring use of methylphenidate. CONCLUSIONS This tumor has a favorable prognosis even with elevated MiB and in the setting of recurrence. Treatment for recurrence may include GTR and conformal RT with temozolomide. Further research on RT sparing treatments in the adjuvant setting is warranted. Referral for neuropsychological evaluation and symptomatic treatment with methylphenidate should be considered in patients who receive RT.

Duke Scholars

Author Margaret Johnson Neurosurgery